Disminución del gasto cardíaco: revisión integradora

Silva, Ricardo Costa da; Gondim, Micaelle Costa; Melo, Gabriela Moreira; Silva, Viviane Martins da; Cavalcante, Agueda Maria Ruiz Zimmer; Almeida, Miriam de Abreu; Lucena, Amália de Fátima

doi:10.1590/0034-7167-2022-0265

Ricardo Costa da Silva Corresponding author: Ricardo Costa da Silva E-mail: c.ricardocs@gmail.com

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade Federal de Goiás. Goiânia, Goiás, Brazil

https://orcid.org/0000-0002-1355-5262

Micaelle Costa Gondim

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade Federal de Goiás. Goiânia, Goiás, Brazil

https://orcid.org/0000-0003-1997-7308

Gabriela Moreira Melo

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

Universidade Federal de Goiás. Goiânia, Goiás, Brazil

https://orcid.org/0000-0001-7951-9021

Viviane Martins da Silva

contributed to the analysis and/or interpretation of data

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade Federal do Ceará. Fortaleza, Ceará, Brazil

https://orcid.org/0000-0002-8033-8831

Agueda Maria Ruiz Zimmer Cavalcante

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade Federal de Goiás. Goiânia, Goiás, Brazil

https://orcid.org/0000-0003-3910-2162

Miriam de Abreu Almeida

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil

https://orcid.org/0000-0002-4942-9882

Amália de Fátima Lucena

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final revision with critical and intellectual participation in the manuscript

Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil

https://orcid.org/0000-0002-9068-7189

Corresponding author: Ricardo Costa da Silva E-mail: c.ricardocs@gmail.com

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Mellina Yamamura

	Controlled descriptors	Uncontrolled descriptors
Strategy 1 (broad)	Cardiac Output [MeSH Terms]; Cardiac Output, Low [MeSH Terms]; cardiac output, decreased [Título CINAHAL];‘heart output’ [emtree]; Débito Cardíaco [DeCS]; Baixo Débito Cardíaco [DeCS]	decreased; risk; diminuído; risco
Strategy 2 (restricted)	Cardiac Output [MeSH Terms]; Cardiac Output, Low [MeSH Terms]; cardiac output, decreased [Título CINAHAL]; Débito Cardíaco [DeCS]; Baixo Débito Cardíaco [DeCS]; ‘heart output’ [emtree]; NANDA Nursing Diagnoses [Título CINAHAL];‘nursing diagnosis’ [emtree]	decreased; risk; diminuído; risco; nursing diagnos*; Diagnósticos de Enfermagem

Study	Author, year, and country	Design	Objective	LoE	Context	DCO
S1(¹²)	Garan et al., (2010) - USA	Retrospective longitudinal	Investigate whether peripheral vascular compensatory mechanisms are preserved after orthotopic heart transplantation.	IV	36 medical records of hospitalized patients in 38 months	Phenomenon
S2(¹³)	Paganin et al., (2010) - Brazil	Cross-sectional	Map the Nursing Interventions Classification interventions with the most prevalent NDs in the first 24 hours of patient admission to the Intensive Care Unit.	VI	150 medical records of hospitalized individuals	ND
S3(¹⁴)	Paganin et al., (2010) - Brazil	Cross-sectional	Identify the main ND established in an Intensive Care Unit and compare them between clinical and surgical patients.	VI	150 medical records of hospitalized individuals	ND
S4(¹⁵)	Martins, Aliti, Rabelo (2010) - Brazil	Cross-sectional	Validate DCO in patients with decompensated HF hospitalized in Intensive and Emergency Care Units.	VI	29 hospitalized patients	ND
S5(¹⁶)	Alessandra, Silla, Marilisia (2011) - Italy	Cross-sectional	Describe the use of nursing terminology in care plans provided to patients in a cardiology rehabilitation unit.	VI	76 outpatient patients	ND
S6(¹⁷)	Aliti etal., (2011) - Brazil	Cross-sectional	Identify the signs and symptoms to infer the main ND in patients with decompensated HF.	VI	303 hospitalized patients	ND
S7(¹⁸)	Bodetofta et al., (2011) - Sweden	Randomized clinical trial	Check whether inhaling oxygen decreases cardiac output and blood flow.	II	16 healthy volunteers	Phenomenon
S8(¹⁹)	Pereira et al., (2011) - Brazil	Cross-sectional	Identify the frequency of ND and DC in patients with cardiovascular diseases and characterize them in terms of sociodemographic and clinical variables.	VI	30 hospitalized patients	ND
S9(²⁰)	Scherb et al., (2011) - USA	Multicentric comparative	Compare the ten most frequent diagnoses, interventions and nursing outcomes in patients hospitalized for HF.	VI	302 medical records of hospitalized patients	ND
S10(²¹)	Matos et al., (2012) - Brazil	Cross-sectional	Assess the prevalence of DC and to analyze which are the predictive factors of DCO in patients with HF undergoing assessment for heart transplantation.	VI	38 hospitalized patients using Pulmonary Artery Catheter	ND
S11(²²)	Kyhl et al., (2013) - Denmark	Non-randomized clinical study	Check whether positive pressure ventilation reduces cardiac output.	III	18 healthy volunteers	Phenomenon
S12(²³)	Wajima et al., (2013) - Japan	Randomized clinical trial	Identify and compare hemodynamic parameters for probable hypotension during patient commuting to bed after different types of anesthesia (general, epidural or spinal combined with general).	II	69 patients hospitalized in the immediate postoperative period of elective surgery	Phenomenon
S13(²⁴)	Hargens et al., (2015) - USA	Randomized clinical trial	Determine whether resting hemodynamic variables are altered in individuals with OSA entering cardiac rehabilitation compared to those without apnea.	II	73 individuals in outpatient cardiac rehabilitation	Phenomenon
S14(²⁵)	Kasai et al., (2015) - Canada	Non-randomized clinical trial	Investigate whether, in patients with HF, those with OSA have greater reductions in stroke volume and cardiac output and whether these decreases are proportional to the severity of OSA.	III	60 outpatient patients	Phenomenon
S15(²⁶)	Li et al., (2015) - China	Case-control study	Investigate total peripheral vascular resistance, cardiac output and natriuretic peptide levels in children with PTS during supine, orthostatic and return to supine positions.	IV	29 children with PTS in the case group and 32 controls	Phenomenon
S16(²⁷)	Ma et al., (2015) - USA	Longitudinal	Assess the short-term cardiovascular response to prone position in neonates in neonatal intensive care.	IV	30 neonates hospitalized for 10 minutes	Phenomenon
S17(²⁸)	Souza et al., (2015) - Brazil	Cross-sectional	Assess the clinical usefulness of operational definitions for DC DCO, excessive fluid volume and impaired activity tolerance, and the concomitant presence of these diagnoses in patients with HF decompensation.	VI	25 hospitalized patients	ND
S18(²⁹)	Chikhani et al., (2016) - England	Non-randomized clinical study	Investigate the effect of prone position using surgical pads on hepatic blood flow and cardiovascular behavior in healthy subjects.	III	10 healthy volunteers	Phenomenon
519(³⁰)	Costa, Linch, Souza (2016) - Brazil	Cross-sectional	Identify the main signs and symptoms of patients with heart disease admitted to an intensive cardiac care unit and infer the main ND.	VI	77 medical records of hospitalized individuals	ND
S20(³¹)	Galvão et al., (2016) - Brazil	Cross-sectional	Identify priority NDs for patients with decompensated HF admitted to a cardiology emergency room at a university hospital.	VI	62 hospitalized patients	ND
S21(³²)	Pereira et al., (2016) -Brazil	Longitudinal	Identify the ND fatigue, DCO and activity intolerance and verify the association of DD with the respective ND in patients hospitalized with HF.	IV	72 patients followed up during three weeks of hospitalization	ND
S22(³³)	Sánchez et al., (2016) - Colombia	Cross-sectional	Determine the clinical and construct validity of ND DCO in patients with HF.	VI	200 hospitalized patients	ND
S23(³⁴)	Yang et aI., (2016) - China	Randomized clinical trial	Explore the effects of stress hyperglycemia on cardiac function and prognosis in critically ill intensive care patients.	II	80 hospitalized patients	Phenomenon
S24(³⁵)	Miró et al., (2017) - Italy	Non-randomized clinical study	Investigate changes in left ventricular systolic function due to thoracic epidural anesthesia and changes in hemodynamic variables and left ventricular diastolic function in patients undergoing major abdominal surgery.	III	24 hospitalized without significant heart disease	Phenomenon
S25(³⁶)	Paviotti, Todero, Demarini (2017) - Italy	Longitudinal	Verify the short-term effects of the left lateral position on the cardiovascular parameters of hemodynamically stable newborns.	IV	32 neonates hospitalized for 10 minutes	Phenomenon
S26(³⁷)	Nederend et al., (2018) - Netherlands	Randomized clinical trial	Assess cardiac autonomic nervous system activity and cardiac function in children after aortic coarctation repair and investigate the relationship between the two.	II	31 outpatient patients	Phenomenon
S27(³⁸)	Slomko et al., (2018) - Poland	Randomized clinical trial	Analyze the impact of sleep deprivation on hemodynamic and autonomic parameters in subjects with normal blood pressure, compared with prehypertension and hypertension, at 24, 28 and 32 hours of total sleep deprivation.	II	30 healthy volunteers	Phenomenon
S28(³⁹)	Stewart et al., (2018) - USA	Case-control study	Investigate whether postural hyperventilation is one of the causes of PTS and whether there is associated hyperventilation when there is a reduction in cardiac output.	IV	58 cases with PTS and 16 healthy controls	Phenomenon
S29(⁴⁰)	Ribeiro et al., (2019) - Brazil	Cross-sectional	Assess ND Frail Elderly Syndrome in older adults with chronic diseases in a health district in the Federal District.	VI	78 community older adults	ND
S30(⁴¹)	Zhang et al., (2021) - China	Case-control study	Analyze the associations of cardiac function with inflammatory cytokines, oxidative stress and anemia in patients with uremia.	IV	43 patients in uremia in the case group and 36 patients in the control group	Phenomenon
S31(⁴²)	Perry et al.,(2021)- England	Longitudinal	Describe hemodynamic differences in women with gestational hypertension.	IV	717 pregnant women followed up during 77 months	Phenomenon

Possible new related factors	Studies
Hyperglycemic stress	S23(³⁴)
Prone position	S16(²⁷);S18(²⁹)
Left side position	S25(³⁶)
Sleep deprivation	S27(³⁸)

Possible new associated conditions
Obstructive sleep apnea	S13(²⁴); S14(²⁵)
Coarctation of the aorta	S26(³⁷)
Gestational hypertension	S31(⁴²)
Anesthetic procedure	S24(³⁵)
Postural tachycardia syndrome	S15(²⁶); S28(³⁹)
Transplantation	S1(¹²)
Oxygen therapy	S7(¹⁸)
Uremia	S30(⁴¹)
Positive pressure ventilation	S11(²²)

Possible new populations at risk
Individuals with a history of cardiovascular disease	S4(¹⁵); S5(¹⁶); S6(¹⁷); S8(¹⁹); S9(²⁰); S10(²¹); S13(²⁴); S14(²⁵); S17(²⁸); S19(³⁰); S20(³¹); S21(³²); S22(³³); S27(³⁸); S29(³⁸); S31(⁴²)
Male	S3(¹⁴); S4(¹⁵); S6(¹⁷); S13(²⁴); S14(²⁵); S17(²⁸); S20(³¹); S21(³²); S22(³³); S24(³⁵)

[TFN2] S - study; LoE - level of evidence; ND - Nursing Diagnosis(s); HF - heart failure; DCO - Decreased Cardiac Output; OSA - obstructive sleep apnea; PTS - Postural Tachycardia Syndrome.

Disminución del gasto cardíaco: revisión integradora

RESUMEN